title: Real-time noninvasive estimation of intrapleural pressure in mechanically ventilated patients: a feasibility study.
abstract: A method for real-time noninvasive estimation of intrapleural pressure in mechanically ventilated patients is proposed. The method employs a simple first-order lung mechanics model that is fitted in real-time to flow and pressure signals acquired non-invasively at the opening of the patient airways, in order to estimate lung resistance (RL), lung compliance (CL) and intrapleural pressure (Ppl) continuously in time. Estimation is achieved by minimizing the sum of squared residuals between measured and model predicted airway pressure using a modified Recursive Least Squares (RLS) approach. Particularly, two different RLS algorithms, namely the conventional RLS with Exponential Forgetting (EF-RLS) and the RLS with Vector-type Forgetting Factor (VFF-RLS), are considered in this study and their performances are first evaluated using simulated data. Simulations suggest that the conventional EF-RLS algorithm is not suitable for our purposes, whereas the VFF-RLS method provides satisfactory results. The potential of the VFF-RLS based method is then proved on experimental data collected from a mechanically ventilated pig. Results show that the method provides continuous estimated lung resistance and compliance in normal physiological ranges and pleural pressure in good agreement with invasive esophageal pressure measurements.
authors.forename: Antonio
authors.initials: A
authors.lastname: Albanese
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Karamolegkos
authors.forename: Syed W
authors.initials: SW
authors.lastname: Haider
authors.forename: Adam
authors.initials: A
authors.lastname: Seiver
authors.forename: Nicolas W
authors.initials: NW
authors.lastname: Chbat
mesh_terms: D000465:Algorithms; D000818:Animals; D005240:Feasibility Studies; D006801:Humans; D016018:Least-Squares Analysis; D008168:Lung / Q000503:physiopathology; D008297:Male; D008954:Models, Biological; D035422:Pleural Cavity / Q000503:physiopathology*; D011312:Pressure; D012121:Respiration, Artificial; D012815:Signal Processing, Computer-Assisted; D013552:Swine; D013997:Time Factors